Abstract
BackgroundUntreated chronic shoulder dislocation eventually leads to functional disability and pain. Open reduction with different fixation methods have been introduced for most chronic shoulder dislocation. We hypothesized that open reduction and simultaneous Bankart lesion repair in chronic anterior shoulder dislocation obviates the need for joint fixation and leads to better results than previously reported methods.MethodsEight patients with chronic anterior dislocation of shoulder underwent open reduction and capsulolabral complex repair after an average delay of 10 weeks from injury. Early motion was allowed the day after surgery in the safe position and the clinical and radiographic results were analyzed at an average follow-up of one year.ResultsThe average Rowe and Zarin's score was 86 points. Four out of eight shoulders were graded as excellent, three as good and one as fair (Rowe and Zarins system). All patients were able to perform their daily activities and they had either mild or no pain. Anterior active forward flexion loss averaged 18 degrees, external active rotation loss averaged 17.5 degrees and internal active rotation loss averaged 3 vertebral body levels. Mild degenerative joint changes were noted in one patient.ConclusionThe results show that the overall prognosis for this method of operation is more favorable than the previously reported methods and we recommend concomitant open reduction and capsulolabral complex repair for the treatment of old anterior shoulder dislocation.Level of EvidenceTherapeutic study, Level IV (case series [no, or historical, control group])
Highlights
A glenohumeral joint that has remained dislocated for several days is called a chronic dislocation
Open reduction and joint fixation has been suggested for most unreduced anterior dislocation of shoulder and different fixation methods have been used to prevent
Given the documented success following Bankart lesion repair in recurrent anterior shoulder dislocation [9], we hypothesized that open reduction and simultaneous Bankart lesion repair of chronic anterior shoulder dislocation has the beneficial effect of safe early motion without the risk of redislocation
Summary
A glenohumeral joint that has remained dislocated for several days is called a chronic dislocation. These old dislocations most often are traumatic but frequently have been produced by a trivial injury as a result of the patient's increasing age and weakness and degeneration of the soft tissue about the shoulder joint such as the subscapularis and other rotator cuff tendons [1,2]. Open reduction and joint fixation has been suggested for most unreduced anterior dislocation of shoulder and different fixation methods have been used to prevent. We hypothesized that open reduction and simultaneous Bankart lesion repair in chronic anterior shoulder dislocation obviates the need for joint fixation and leads to better results than previously reported methods
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